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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this research was to identify any early cardiovascular changes that may be predictive of future hypertension in young subjects with family history of hypertension. The study was conducted on 25 offspring of hypertensive parents, mean age 17 years (22 with hypertension only in 1 parent and 3 with both hypertensive parents) and 20 offspring of both normotensive parents, matched by age. Subjects were divided into children (7-13 years) and young adults (19 years on). All subjects underwent three office blood pressure measurements with a mercury sphygmomanometer. On the third control, BoMed thoracic electrical bioimpedance at rest and during upright bicycle exercise was performed. Physical characteristics were similar in subjects matched by age in the two groups. Systolic blood pressure was similar in offspring of normotensives and hypertensives, both at rest and during exercise; diastolic blood pressure was greater in offspring of hypertensive parents at rest (73.1 +/- 10.5 vs 63.5 +/- 7.1 mmHg, p < 0.05), during the first minutes of exercise and during the recovery phase (p < 0.05). Moreover, at the third blood pressure measurement at rest, diastolic blood pressure decreased, with respect to the first measurement, only in children and young adult offspring of normotensive parents, while systolic blood pressure decreased in the two groups of child subjects. No differences in heart rate were observed, both at rest and during physical exercise, between offspring of normotensives and hypertensives. Left ventricular end-diastolic volume, stroke volume, ejection fraction, cardiac output and systemic vascular resistance at rest and their response to decubitus changes and exercise were normal and similar in offspring of normotensive and hypertensive parents both in children and young adults. In conclusion, a different behavior of diastolic blood pressure was found in offspring of hypertensive parents compared to that of normotensive parents, both in children and, to a higher degree, in young adults. This may be an expression of early vascular change in subjects with a genetic predisposition to hypertension.
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PMID:[Hemodynamic assessment at rest and during dynamic physical exercise in young subjects with and without hypertensive parents]. 864 Aug 51

The stroke volume of the left ventricle (SV) was assessed in nine young men (mean age 22.2, ranging from 20 to 25 years) during cycle ergometer upright exercise at exercise intensities from 60 to 150 W (about 20% to 80% of individual maximal aerobic power). The SV was calculated from noninvasive tracings of the arterial blood pressure, determined from photoplethysmograph records and compared to the SV determined simultaneously by pulsed Doppler echocardiography (PDE). Given the relationship SV = As.Z-1 in which A(s) is the area underneath the systolic pressure profile (in millimetres of mercury and second), and Z (in millimetres of mercury and second per millilitre) is the apparent hydraulic impedance of the circulatory system, a prerequisite for the assessment of SV from the photoplethysmograph tracings is a knowledge of Z. The experimental value of Z (hereafter defined Z*) was calculated by dividing A(s) (from the finger photoplethysmograph) by SV as obtained by PDE. When the whole group of subjects was considered, Z* was not greatly affected by the exercise intensity: it amounted to 0.089 (SD 0.028; n = 36). The Z was also estimated independently of any parameter other than heart rate (HR), mean (MAP) and pulse (PP) arterial blood pressure obtained from the photoplethysmograph. A computerized statistical method allowed us to interpolate the experimental values of Z*, HR, PP and MAP by the equation Zm = a.(b + c.HR + d.PP + e.MAP)-1, thus obtaining the coefficients a to e. The mean percentage error between Zm (calculated from the coefficients obtained and Z* was 21.8 (SD 14.3)%. However, it was observed that, in a given subject, Z* was significantly affected by the exercise intensity. Therefore, to improve the estimate of Z a second algorithm was developed to update the experimental value of Z determined initially at rest (Zin). This updated value (Zcor) of Z was calculated as Zcor = Zin. [(f/(i + g.(HR/HRin) + h.(PP/PPin) + 1.(MAP/MAPin)], where HRin, PPin, MAPin, HR, PP, MAP are the above parameters at rest and during exercise, respectively. Also in this case, the coefficients f to 1 were determined by a computerized statistical method using Z* as the experimental reference. The values of Zcor so obtained allowed us to calculate SV from arterial pulse contour analysis as SVF = As.Z-1cor. The mean percentage error between the SVF obtained and the values simultaneously determined by PDE, was 10.0 (SD 8.7)%. It is concluded that the SV of the left ventricle, and hence cardiac output, can be determined during exercise from photoplethysmograph tracings with reasonable accuracy, provided that an initial estimate of SV at rest is made by means an independent high quality reference method.
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PMID:Noninvasive assessment of cardiac output from arterial pressure profiles during exercise. 878 65

The aim of this multicenter study was to evaluate the efficacy and tolerability of manidipine hydrochloride, a new calcium-antagonist of the dihydropyridine group, in the long-term treatment of mild to moderate hypertension. After a 2-week run-in period on placebo, 183 patients, 98 males and 85 females, with mean age of 53.8 years, sitting DBP > or = 95 and < or = 115 mmHg and SBP < or = 210 mmHg, were given manidipine 10 mg once daily. Two weeks later, patients whose DBP was > or = 90 mmHg or with a reduction in DBP < 10 mmHg were administered with manidipine 20 mg once daily. Follow-up visits were performed at 6, 10, 14, 26, 38 and 52 weeks after starting manidipine treatment. All BP (by mercury sphygmomanometer, Korotkoff I and V) and heart rate (HR) measures were made 24 h after dosing. Adverse events and laboratory data were recorded. Particular attention was paid to the collection of possible major cardiovascular (angina pectoris, myocardial infarction) and cerebrovascular (IRA, stroke) events, observed during the treatment period. One-hundred-and-fifty-one patients completed the study (79 on a 10 mg dose and 72 on a 20 mg dose), whereas 32 dropped out (11 lost to follow-up, 11 insufficient therapeutic response, 7 ADRs, 3 other causes). Significant reductions of BP values were achieved during the manidipine 10 mg treatment period. Analysis of covariance between doses confirmed a more potent hypotensive effect of manidipine 20 mg as compared to 10 mg on sitting DBP and mean BP and on standing SBP, especially in patients with moderate hypertension. At the end of 1 year of treatment the success rates (defined as sitting DBP > or = 90 mmHg or a reduction of > or = 10 mmHg vs baseline) were similar in the two groups (manidipine 10 mg: 96.1%; manidipine 20 mg: 94.5%). No clinically relevant change in HR was observed. Overall, 28 patients (17 in the manidipine 20 mg and 11 in the manidipine 10 mg treated group) complained of adverse events, the most common being ankle oedema (4.9%), headache (3.8%), palpitation (2.7%) and flushing (2.2%). Neither cardiovascular nor cerebrovascular events or other serious adverse event were reported. In conclusion, a significant and constant reduction of BP values was observed with long-term treatment with manidipine. The reduction in BP was dose-related especially in patients suffering from moderate hypertension. Adverse events were mild and relatively more frequent with the higher manidipine dosage.
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PMID:Efficacy and tolerability of manidipine hydrochloride in the long-term treatment of mild-moderate hypertension. Manidipine Efficacy in Long-Term Treatment Group. 897 89

A 19-year-old man was admitted to hospital because of uncharacteristic neurologic symptoms. During the first examination morphologic alterations due to an injection of mercury into the left arm and the left side of the trunk were found. The dose and the manner of application were doubtful and suspected to be a case of self-infliction. The man informed the police only 7 months later because his relatives had finally persuaded him to do so. The description of the infliction by unknown perpetrators was full of contradictions. Initially the patient gave only an indistinct description. But later on, the number of details increased. At the same time there was a change in the characteristics of the perpetrator(s). Other differences existed concerning a loss of consciousness which should have been caused by a single stroke on an arm. Furthermore, the patient told about a swelling as big as an egg, provoked by an injection of liquid mercury. It could be shown by experiments that mercury can be injected into soft-tissue very simply and that it spreaded widely. Arguments for a self-injection were e.g. the technical possibility, the topography of the injection marks, and an easy handling of the syringe. A psychiatric examination furthermore revealed, that the patient had had periods of restriction of thinking, sometimes combined with a lack of appreciation.
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PMID:[Heavy metal incorporation as an unusual self-injury]. 964 50

A prospective population study of women in Gothenburg, Sweden was started in 1968-69 and comprised 1462 women aged 38, 46, 50, 54, or 60 years at baseline. Follow-up studies were carried out in 1974-75, 1980-81, and 1992-93. The baseline study included an extensive medical and dental examination. Serum mercury concentration (beta-HG) was determined in deep-frozen samples from all participants in 1968-69 and in a random subsample of sera from participants in 1980-81, about 20 years after the baseline examination. S-Hg was statistically significantly correlated with number of amalgam fillings at both examinations. Of 30 defined symptoms and 4 different clusters of symptoms, no one was independently correlated with S-Hg measured in the samples from 1968-69, while there was a negative statistically significant correlation with over-exertion and poor appetite in 1980-81. Blood hemoglobin and serum B-12 concentrations in 1968-69 were statistically significantly and positively correlated with S-Hg, while erythrocyte sedimentation rate and the serum concentrations of potassium and triglycerides were significantly and negatively correlated with S-Hg, also after including potential confounders. Blood hematocrit examined in 1980-81 was negatively correlated with S-Hg. When including potential confounders, serum IgA was also statistically significantly correlated with S-Hg, but not in univariate analysis. No statistically significant correlation was observed between S-Hg, on the one hand, and the incidence of diabetes, myocardial infarction, stroke, or cancer on the other, while a statistically significant negative correlation was observed with overall mortality when age and education were included as background variables. There were some correlations between biological variables and S-Hg, probably of no negative clinical significance, and we conclude that there is no association between disease and S-Hg on a population basis in middle-aged and older women.
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PMID:Serum mercury concentration in relation to survival, symptoms, and diseases: results from the prospective population study of women in Gothenburg, Sweden. 1048 Feb 84

Left ventricular hypertrophy (LVH), a target-organ response to chronic pressure or volume overload, is associated with its own independent risks of death in patients with hypertension. Numerous studies have shown that LVH increases the risk of coronary heart disease, congestive heart failure, stroke or transient ischemic attack, all-cause deaths, and sudden death. Although the mechanisms by which LVH develops are incompletely understood, the renin-angiotensin system may play an important role. All major classes of antihypertensive agents (calcium channel blockers, diuretics, beta-blockers, angiotensin-converting enzyme inhibitors) can cause LVH regression but not all to the same degree. Angiotensin-converting enzyme inhibitors may provide the most pronounced reduction in left ventricular mass per millimeter of mercury of blood pressure reduction. In addition, animal studies and human trials show promise for the regression of LVH with the use of angiotensin receptor blockers (ARBs). Because ARBs act specifically on the AT(1) receptor, angiotensin II can exert its favorable effects on cell growth inhibition through the AT(2) receptor. One small study that compared the ARB valsartan with atenolol found significant regression of LVH with the ARB by 8 months of treatment.
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PMID:Therapeutic options in minimizing left ventricular hypertrophy. 1061 82

Valsalva manoeuvre is reported to be sometimes successful for the relief of angina pectoris. The present study investigated how haemodynamic changes produced by Valsalva manoeuvre can interact to improve the relationship between cardiac work and coronary blood flow. Ten male subjects aged 53 +/- 12 years (SD) were considered. Blood velocity in the internal mammary artery, previously anastomosed to the left descending coronary artery, was studied with Doppler technique. The subjects performed Valsalva manoeuvres by expiring into a tube connected to a mercury manometer, to develop a pressure of 40 mmHg. The arterial blood pressure curve was continuously monitored with a Finapres device from a finger of the left hand. During expiratory effort, an increase in heart rate and a decrease in arterial pulse pressure were followed by a more delayed and progressive increase in mean and diastolic pressures. Systolic blood velocity markedly decreased along with the reduction in pulse pressure and increase in heart rate. By contrast, diastolic and mean coronary blood velocities did not show any significant change. Since it is known that the Valsalva manoeuvre strongly reduces stroke volume and cardiac output, it is likely that a reduction in cardiac work also takes place. Since in diastole, i.e. when the myocardial wall is better perfused, coronary blood velocity did not show any significant reduction, it is likely that unchanged perfusion in the presence of reduced cardiac work is responsible for the relief from angina sometimes observed during Valsalva manoeuvre. It is also likely that the increase in heart rate prevents the diastolic and mean blood coronary velocity from decreasing during the expiratory strain, when an increased sympathetic discharge could cause vasoconstriction through the stimulation of the coronary alpha-receptors.
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PMID:Systolic and diastolic changes in human coronary blood flow during Valsalva manoeuvre. 1065 88

Number of dental amalgam fillings and baseline serum mercury concentration were assessed with respect to a number of health related variables as part of a population study of women. There was no increased incidence of symptoms, no derangement of laboratory variables of clinical significance, nor any increased mortality or increased risk of myocardial infarction, stroke, diabetes or cancer in women with many amalgam fillings compared with those with few fillings, nor in women with higher serum mercury concentration compared with those with lower serum mercury concentration.
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PMID:[No connection between the number of amalgam fillings and health. Epidemiological observations from a population study of women in Gothenburg]. 1129 70

Hypertension is one of the most important risk factors for ischaemic heart disease and stroke. The aim of our study was to assess the antihypertensive effect of angiotensine converting enzyme inhibitor (perindopril) versus beta blocker (acebutolol) in hypertensive patients. It was a double blind, placebo controlled study performed in the group of 31 patients (16 males, 15 females; mean age 46.6 +/- 8.7 years) with newly diagnosed (previously not treated) mild to moderate hypertension. Each patient in the wash-out period (two weeks) was given placebo and then was randomized to active treatment: perindopril (4 mg/day) or acebutolol (400 mg/day) for 3 weeks, following these drugs were cross matched (after one week wash out period). Blood pressure (BP) with mercury sphygmomanometer was measured three times: after 2 weeks of placebo treatment, after 3 weeks of perindopril and 3 weeks of acebutolol treatment. Both perindopril and acebutolol proved to be effective in monotherapy of hypertension. After 3 weeks of the treatment we observed BP systolic and diastolic normalization, but more patients had systolic BP normalization after perindopril treatment.
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PMID:[The comparison of clinical effectiveness of perindopril and acebutolol in the primary hypertension treatment]. 1160 73

Major concerns remain about the reliability of tympanic thermometers. The aim of this study was to investigate the agreement between rectal and tympanic thermometry and compare this with the repeatability of each method in patients with acute stroke. Tympanic temperature readings were from 0.7 degrees C below to 0.8 degrees C above rectal readings. As to repeatability, we found second rectal readings to be between 0.3 degrees C below and 0.4 degrees C above first readings, and second tympanic readings to be between 0.4 degrees C below and 0.5 degrees C above first readings. The agreement between the two methods is acceptable in clinical practice. Tympanic thermometry is useful in serial measurements, whereas, for a single accurate measurement, rectal mercury thermometry remains the method of choice.
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PMID:Acceptable agreement between tympanic and rectal temperature in acute stroke patients. 1192 10


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